Short- and Midterm Comparison of Platelet-Rich Plasma with Hyaluronic Acid versus Leucocyte and Platelet-Rich Plasma on Pain and Function to Treat Hip Osteoarthritis. A Retrospective Study

Hip osteoarthritis (HOA) leads to pain and reduced function. The use of intra-articular injections based on corticosteroids, platelet-rich plasma (PRP), or hyaluronic acid (HA) is becoming a common symptomatic therapy for HOA. For the first time, we compare the effectiveness of plasma with a high concentration of platelets and leukocytes (L-PRP) with PRP+HA in patients with mild to moderate HOA. A total of 26 patients in each group were administered with either L-PRP or PRP+HA. Outcomes were evaluated at baseline, 3 months, and 1 year after the injection. The mean visual analog scale (VAS) and Harris hip score (HHS) within and between groups among different time points were compared using repeated measures ANCOVA (age set as a covariate). Both treatments were effective in reducing VAS, but not in significantly increasing HHS. In the group treated with L-PRP, VAS showed interaction between time and treatment (in favor of L-PRP). Pairwise comparison for treatment and time point evidenced a significant difference at 1-year follow-up between L-PRP and PRP-HA. Outcomes support the idea that both treatments may be effective in reducing pain, with maximal pain reduction achieved after 3 months. L-PRP showed better results in reducing VAS over time. Both treatments are effective at reducing pain in the short to medium term. L-PRP could be the treatment of choice due to a more marked effect over time. Nevertheless, further research is needed to better describe the clinical outcome of these formulations.

Download Full-text

Treatment of Early Hip Osteoarthritis: Ultrasound-Guided Platelet Rich Plasma versus Hyaluronic Acid Injections in a Randomized Clinical Trial

Joints ◽

10.1055/s-0037-1605584 ◽

2017 ◽

Vol 05 (03) ◽

pp. 152-155 ◽

Cited By ~ 33

Author(s):

Carlo Doria ◽

Giulia Mosele ◽

Gianfilippo Caggiari ◽

Leonardo Puddu ◽

Emanuele Ciurlia

Keyword(s):

Hyaluronic Acid ◽

Platelet Rich Plasma ◽

Controlled Trial ◽

Hip Osteoarthritis ◽

Harris Hip Score ◽

Ultrasound Guided ◽

Level Of Evidence ◽

Level Ii ◽

Group 2 ◽

Double Blinded

Purpose The aim of this study was to compare the clinical efficacy of ultrasound-guided intra-articular injections of autologous platelet rich plasma (PRP) versus hyaluronic acid (HA) for symptomatic early osteoarthritis (OA) of the hip. Methods A prospective controlled double-blinded randomized trial on 80 patients with hip OA was conducted. The patients were divided in two groups of 40 patients each: group 1 underwent three PRP intra-articular ultrasound-guided injections, whereas group 2 underwent three HA injections. WOMAC, VAS, and Harris Hip Score were evaluated for both groups before and at 6 and 12 months after treatment. Results The two groups were comparable in age, sex, body mass index, and severity of hip OA. Both groups showed a significant improvement from baseline at 6-month and 12-month follow-ups for all the outcome measures. No major complications were observed during the treatment and at follow-ups in both the groups. Conclusion PRP did not offer significantly better results compared with HA in patients with moderate signs of OA, and thus it should not be considered as first-line treatment. Level of Evidence Level II, randomized controlled trial.

Download Full-text

Platelet-Rich Plasma Combined with Hyaluronic Acid versus Leucocyte and Platelet-Rich Plasma in the Conservative Treatment of Knee Osteoarthritis. A Retrospective Study

Medicina ◽

10.3390/medicina57030232 ◽

2021 ◽

Vol 57 (3) ◽

pp. 232

Author(s):

Michelangelo Palco ◽

Domenico Fenga ◽

Giorgio Carmelo Basile ◽

Paolo Rizzo ◽

Bruno Cavalieri ◽

...

Keyword(s):

Hyaluronic Acid ◽

Knee Osteoarthritis ◽

Repeated Measures ◽

Platelet Rich Plasma ◽

Clinical Effectiveness ◽

High Concentration ◽

Negative Effect ◽

And Function ◽

Change In Mean

Background and objectives: Knee osteoarthritis (KO) is one of the most common joint diseases, determining knee pain and reduction of mobility, with a negative effect on quality of life. Intra-articular injections of different formulations of platelet-rich plasma (PRP) are an increasingly common non-surgical treatment for KO. Recently, in order to combine the anti-inflammatory effect of platelet rich plasma and the viscosupplementation effect of hyaluronic acid, a formulation of PRP combined with hyaluronic acid (PRP + HA) has been proposed. The purpose of this study is to retrospectively compare the effectiveness of plasma with high concentration of platelets and leukocytes (L-PRP) with PRP + HA in patients with mild to moderate (Kellgren–Lawrence scale II-III grade) KO. Materials and Methods: Among the 51 patients included, 28 have been treated with L-PRP, while 23 with PRP + HA. A retrospective evaluation at baseline (T0), after 3 months (T1) and 1 year (T2) has been performed. The outcome analyzed are the Knee Society Score (KSS), the Visuo Analogic Scale (VAS) (at T0, T1, and T2) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) (T0 and T2). We evaluated change in mean scores within and between groups among different time points using repeated measures ANCOVA. Results: Although the two treatments have been both effective in reducing VAS, the group treated with PRP + HA showed a significantly lower KSS. Conclusions: Our results show that the use of both treatments may help to reduce pain in patients with mild to moderate KO. PRP + HA showed better results in improving knee mobility and function. These results should be considered only preliminary: Further research is needed to completely describe the clinical effectiveness of these formulations.

Download Full-text

Effectiveness of plasma with low concentration of platelets combined with hyaluronic acid compared with platelet rich plasma in the conservative treatment of knee osteoarthritis. A retrospective study

10.21203/rs.3.rs-107447/v1 ◽

2020 ◽

Author(s):

Michelangelo Palco ◽

Domenico Fenga ◽

Paolo Rizzo ◽

Bruno Cavalieri ◽

Demetrio Milardi ◽

...

Keyword(s):

Hyaluronic Acid ◽

Knee Osteoarthritis ◽

Functional Status ◽

Repeated Measures ◽

Platelet Rich Plasma ◽

High Concentration ◽

Low Concentration ◽

One Year ◽

Change In Mean

Abstract Background: Knee osteoarthritis (KO) is one of the most common joint diseases, often determining knee pain and reduction of mobility with impact on the overall quality of life of the patients. Intra-articular injections of different formulations of platelet rich plasma (PRP) are an increasingly common non-surgical treatment for KO. Recently, in order to combine the antinflammatory effect of platelet rich plasma and the viscosupplementation effect of hyaluronic acid, a formulation of plasma with relatively low concentration of platelets and very few leukocytes combined with hyaluronic acid (PRP+HA) has been proposed. The purpose of this study is to retrospectively compare the effectiveness of plasma with high concentration of platelets and leukocytes (L-PRP) with PRP+HA in patients with mild to moderate (Kellegren-Lawrence scale II-III grade) KO.Materials and Methods: Among the 51 patients included, 28 have been treated with L-PRP, while 23 with PRP+HA. A retrospective evaluation at baseline (T0), after 3 months (T1) and 1 year (T2) has been performed. The outcome analyzed are the Knee Society Score(KSS), the Visuo Analogic Scale (VAS) (at T0,T1 and T2) and the Knee injury and Osteoarthritis Outcome Score(KOOS) (T0 and T2).We evaluated change in mean scores within group among different time points using repeated measures ANOVA or paired t-test. Comparison between different groups of treatment has been performed using mixed ANOVA.Results: The main finding is that, although the two treatments have been both effective, PRP+HA determined significantly better functional status, pain and mobility, measured with KSS.Discussion: We observed a significant effect of the two formulations in exam in all the outcomes in analysis: both treatments were effective in improving pain, knee functional status and symptoms, and the benefits persisted after 3 and 12 months from the infiltrative therapy. Nevertheless, patients who received PRP+HA injections presented higher knee mobility and better function (measured by KSS score) after one year.Conclusions: This work compares clinical outcomes of L-PRP and PRP+HA treatment in patients with KO. Our results encourage the use of one of the two treatments in patients with mild to moderate KO. When possible, we suggest to the use of PRP+HA formulation, because it may determine better results in improving knee function and mobility.

Download Full-text

Acute Comparative Effect of Foam Rolling and Static Stretching on Range of Motion in Rowers

Sustainability ◽

10.3390/su13073631 ◽

2021 ◽

Vol 13 (7) ◽

pp. 3631

Author(s):

Alfonso Penichet-Tomas ◽

Basilio Pueo ◽

Marta Abad-Lopez ◽

Jose M. Jimenez-Olmedo

Keyword(s):

Range Of Motion ◽

Repeated Measures ◽

Static Stretching ◽

Foam Rolling ◽

Significant Difference ◽

Post Test ◽

Alternating Treatment Design ◽

Stroke Amplitude ◽

Treatment Design ◽

Over Time

Rowers’ anthropometric characteristics and flexibility are fundamental to increase stroke amplitude and optimize power transfer. The aim of the present study was to analyze the effect of foam rolling and static stretching on the range of motion over time. Eight university rowers (24.8 ± 3.4 yrs., height 182.3 ± 6.5 cm, body mass 79.3 ± 4.6 kg) participated in an alternating treatment design study with two-way repeated measures ANOVA. The sit and reach test was used to measure the range of motion. Both in the foam rolling and in the static stretching method, a pre-test (T0), a post-test (T1), and a post-15-min test (T2) were performed. A significant effect was observed on the range of motion over time (p < 0.001), but not for time x method interaction (p = 0.680). Significant differences were found between T0 and T1 with foam rolling and static stretching (p < 0.001, d = 0.4); p < 0.001, d = 0.6). The differences between T0 and T2 were also significant with both methods (p = 0.001, d = 0.4; p < 0.001, d = 0.4). However, no significant difference was observed between T1 and T2 (p = 1.000, d = 0.1; p = 0.089, d = 0.2). Foam roller and static stretching seem to be effective methods to improve the range of motion but there seems to be no differences between them.

Download Full-text

Assessment of Vascular Endothelial Growth Factor in Fresh versus Frozen Platelet Rich Plasma

Journal of Blood Transfusion ◽

10.1155/2015/706903 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 6

Author(s):

Nada Hosny ◽

Fikry Goubran ◽

Basma BadrEldin Hasan ◽

Noha Kamel

Keyword(s):

Vascular Endothelial Growth Factor ◽

Growth Factor ◽

Calcium Gluconate ◽

Platelet Rich Plasma ◽

Vascular Endothelial ◽

High Concentration ◽

Significant Difference ◽

Growth Factor Release ◽

Endothelial Growth Factor ◽

Vegf Release

Platelet rich plasma (PRP) is hemoconcentration with platelets concentration above baseline values and high concentration of many growth factors. The aim of this study was to assess freezing effect on vascular endothelial growth factor (VEGF) release from PRP using two different activation methods to simplify its use in different clinical applications. PRP was prepared using two-centrifugation steps method from 12 qualified blood donors. VEGF concentrations were measured in fresh PRP and after freezing/thawing for one and three weeks with two methods of activation using (i) calcium gluconate and (ii) calcium gluconate and thrombin. Platelets count was significantly increased compared to baseline whole blood values in all fresh and frozen PRP samples (p value was <0.05). No significant difference was found between VEGF concentrations after activating fresh and frozen-thawed PRP samples for one and three weeks by calcium alone or calcium with thrombin, and also no significant difference was found when freezing period was extended from one to three weeks. Our results showed that platelets count does not correlate with variable levels of VEGF. PRP could be prepared once and preserved frozen for at least three weeks for the next treatment sessions and activation with thrombin addition to calcium will not augment the growth factor release.

Download Full-text

Effects of Exercise Restriction on Patients With Anomalous Aortic Origin of a Coronary Artery

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/2150135116674444 ◽

2016 ◽

Vol 8 (1) ◽

pp. 18-24 ◽

Cited By ~ 6

Author(s):

Matthew D. Elias ◽

James Meza ◽

Brian W. McCrindle ◽

Julie A. Brothers ◽

Stephen Paridon ◽

...

Keyword(s):

Coronary Artery ◽

Exercise Capacity ◽

Repeated Measures ◽

Mixed Model ◽

Linear Mixed Model ◽

Multivariable Analysis ◽

Young Patients ◽

Significant Difference ◽

Exercise Restriction ◽

Over Time

Background: Management of young patients with anomalous aortic origin of a coronary artery (AAOCA) may involve exercise restriction. We sought to identify the association of exercise restriction with changes over time in body mass index (BMI) and exercise capacity in this cohort. Methods: We performed a retrospective review of patients with AAOCA seen at The Children’s Hospital of Philadelphia between January 1, 1998, and August 31, 2014. Linear mixed model repeated-measures analysis assessed changes in BMI and exercise capacity. Results: We included 72 patients with a median age at presentation of 12.6 years (interquartile range: 10.1-15.8) and mean follow-up of 3.6 ± 3.0 years. The majority had an anomalous right coronary artery (71%) and interarterial ± intramural coronary course (90%). Surgery was performed in 54%, more often in those with interarterial/intramural course ( P < .001) and symptoms ( P = .003). Most patients (82%) were exercise-restricted on presentation, and restricted patients were older than those who were not restricted ( P = .01). There was no significant difference between restricted and nonrestricted patients in initial BMI z scores, percentage of patients with BMI over 85th percentile (26%) or exercise capacity variables. In univariable analysis, exercise restriction over time was not associated with change in BMI z score ( P = .25) or change in exercise variables. Restriction was not associated with significant change in these variables in multivariable analysis. Conclusions: Although further investigation is warranted to determine the degree of adherence to exercise restriction, the recommendation of restriction alone is not associated with increasing BMI or decreasing exercise performance in the short-term.

Download Full-text

The effect of platelet-rich plasma in patients with early hip osteoarthritis: a pilot study

Journal of Hip Preservation Surgery ◽

10.1093/jhps/hnaa044 ◽

2020 ◽

Author(s):

Victor Ortiz-Declet ◽

David A Iacobelli ◽

Muriel R Battaglia ◽

Cammille C Go ◽

David R Maldonado ◽

...

Keyword(s):

Platelet Rich Plasma ◽

Hip Osteoarthritis ◽

Degenerative Joint Disease ◽

Joint Disease ◽

Harris Hip Score ◽

Post Injection ◽

Mri Findings ◽

Outcome Score ◽

Patient Reported

Abstract We investigate whether platelet-rich plasma (PRP) injections can improve symptoms and function in patients with mild to moderate osteoarthritis (OA). Data were prospectively collected and retrospectively reviewed for all patients receiving PRP intra-articular hip injections between February 2017 and June 2017. The inclusion criteria were patients with a well-preserved joint space (Tönnis 0 or 1) whose magnetic resonance imaging (MRI) findings demonstrated degenerative joint disease or a Tönnis grade of 2. The patient-reported outcomes (PROs) used were the modified Harris Hip Score (mHHS), Hip Outcome Score-Activities of Daily Living Subscale (HOS-ADL), Hip Outcome Score-Sports Specific Subscale (HOS-SSS), International Hip Outcome TOOL (iHOT-12), Single Assessment Numeric Evaluation (SANE) and Mental and Physical aspects of the Veteran RAND 12 Item Health Survey (VR-12M and VR-12P). The visual analog scale (VAS) was utilized to indicate pain. Nine patients (11 hips) were eligible for inclusion. All PROs and VAS improved from pre- to post-injection. These improvements were present at the 3-month follow-up visit and stable until the 12-month follow-up. There was statistically significant improvement for mHHS (P < 0.001), HOS-ADL (P = 0.006), iHOT-12 (P = 0.003) and VR-12M (P = 0.005) at 12 months post-injection. Similarly, VAS improved from 4.1 to 2.3, although the change was not statistically significant. PRP injections significantly improved PROs in all measured scales at time points up to a year after intervention, except for VR-12P and HOS-SSS. In conclusion, patients with early OA of the hip had significant improvement of patient-reported functional outcomes up to 12 months after PRP intra-articular injections.

Download Full-text

Platelet-rich plasma versus hyaluronic acid in the treatment of knee osteoarthritis: a meta-analysis

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-01919-9 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Jia Zhu Tang ◽

Ming Jun Nie ◽

Jian Zhong Zhao ◽

Guang Cheng Zhang ◽

Qing Zhang ◽

...

Keyword(s):

Hyaluronic Acid ◽

Adverse Events ◽

Knee Osteoarthritis ◽

Platelet Rich Plasma ◽

Meta Analysis ◽

Womac Pain ◽

Significant Difference ◽

Vas Scores ◽

Eq Vas

Abstract Background This study aimed to evaluate the clinical efficacy of platelet-rich plasma (PRP) injection compared with hyaluronic acid (HA) injection for patients undergoing knee osteoarthritis. Methods We systematically searched electronic databases including PubMed, Embase, Web of Science, and the Cochrane Library on January 23, 2020 to identify relevant studies issued in English languages. The outcomes evaluating the efficacy of knee osteoarthritis (KOA) treatment were Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores (WOMAC pain, function, stiffness, and total scores) at 1, 3, 6, and 12 months; International Knee Documentation Committee (IKDC) scores, Lequesne Index score, Visual Analog Scale (VAS) scores, EQ-VAS scores, and KOOS scores. The pooled data were analyzed by Stata 12.0. Results A total of 20 RCTs were enrolled in the present meta-analysis. The pooled results demonstrated that platelet-rich plasma (PRP) injection reduced pain more effectively than hyaluronic acid (HA) injection at 6-month and 12-month follow-up evaluated by WOMAC pain scores and VAS scores. EQ-VAS in the patients treated with PRP injection was lower than that in patients with HA injection at 12 months. Moreover, the patients with PRP injection had a better function recovery than those with HA injection at 1-month, 3-month, 6-month, and 12-month follow-up, as evaluated by WOMAC function scores. WOMAC total scores showed significant difference at 6-month and 12-month follow-up. The IKDC scores indicated PRP injection was significantly more effective than HA injection at 3 months and 6 months. However, the Lequesne Index scores, KOOS scores, and adverse events did not show any significant difference between groups. Conclusion Intra-articular PRP injection appeared to be more efficacious than HA injection for the treatment of KOA in terms of short-term functional recovery. Moreover, PRP injection was superior to HA injection in terms of long-term pain relief and function improvement. In addition, PRP injection did not increase the risk of adverse events compared to HA injection.

Download Full-text